scholarly journals Innovative approach to improve information accuracy in a two-district cross-sectional study in Bihar, India

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051427
Author(s):  
Caroline Jeffery ◽  
Marcello Pagano ◽  
Baburam Devkota ◽  
Joseph J Valadez
Keyword(s):  
Decision Making ◽  
Health System ◽  
Survey Data ◽  
Health Management ◽  
Poverty Line ◽  
Cross Sectional Study ◽  
Local Health ◽  
Health Coverage ◽  
Cross Sectional ◽  
Survey Estimates

ObjectiveCombine Health Management Information Systems (HMIS) and probability survey data using the statistical annealing technique (AT) to produce more accurate health coverage estimates than either source of data and a measure of HMIS data error.SettingThis study is set in Bihar, the fifth poorest state in India, where half the population lives below the poverty line. An important source of data, used by health professionals for programme decision making, is routine health facility or HMIS data. Its quality is sometimes poor or unknown, and has no measure of its uncertainty. Using AT, we combine district-level HMIS and probability survey data (n=475) for the first time for 10 indicators assessing antenatal care, institutional delivery and neonatal care from 11 blocks of Aurangabad and 14 blocks of Gopalganj districts (N=6 253 965) in Bihar state, India.ParticipantsBoth districts are rural. Bihar is 82.7% Hindu and 16.9% Islamic.Primary outcome measuresSurvey prevalence measures for 10 indicators, corresponding prevalences using HMIS data, combined prevalences calculated with AT and SEs for each type of data.ResultsThe combined and survey estimates differ by <0.10. The combined and HMIS estimates differ by up to 84.2%, with the HMIS having 1.4–32.3 times larger error. Of 20 HMIS versus survey coverage estimate comparisons across the two districts only five differed by <0.10. Of 250 subdistrict-level comparisons of HMIS versus combined estimates, only 36.4% of the HMIS estimates are within the 95% CI of the combined estimate.ConclusionsOur statistical innovation increases the accuracy of information available for local health system decision making, allows evaluation of indicator accuracy and increases the accuracy of HMIS estimates. The combined estimates with a measure of error better informs health system professionals about their risks when using HMIS estimates, so they can reduce waste by making better decisions. Our results show that AT is an effective method ready for additional international assessment while also being used to provide affordable information to improve health services.

Doctor Retention in Ireland - What it may mean for the Global Health Workforce Reform Agenda Comment on "Doctor Retention: A Cross-sectional Study of How Ireland Has Been Losing the Battle"

2020 ◽  
Author(s):  
Bernard Hope Taderera
Keyword(s):  
Global Health ◽  
Health Workforce ◽  
Cross Sectional Study ◽  
Early Career ◽  
Healthcare Personnel ◽  
Health Coverage ◽  
Cross Sectional ◽  
Middle Income ◽  
Reform Agenda ◽  
Medical Graduates

The study of healthcare personnel migration in Ireland reports that most medical graduates plan to leave the country’s health system. It may be possible to address this challenge by understanding and addressing the reasons why young doctors plan to leave. Future studies should contribute to the retention of early career doctors in highincome countries such as Ireland. This will help reduce the migration of doctors from low- and middle-income countries in order to address the global health workforce crisis and its impact on the attainment of universal health coverage in all health systems.

scholarly journals Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Health System ◽  
Age Groups ◽  
Unmet Need ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Self Medication ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

Observer Ratings of Shared Decision Making Do Not Match Patient Reports: An Observational Study in 5 Family Medicine Practices

2020 ◽  
Vol 41 (1) ◽  
pp. 51-59
Author(s):  
Gisèle Diendéré ◽  
Imen Farhat ◽  
Holly Witteman ◽  
Ruth Ndjaboue
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Risk Communication ◽  
Shared Decision Making ◽  
Cross Sectional Study ◽  
Clinical Encounter ◽  
Values Clarification ◽  
Shared Decision ◽  
Cross Sectional ◽  
Medical Consultations

Background Measuring shared decision making (SDM) in clinical practice is important to improve the quality of health care. Measurement can be done by trained observers and by people participating in the clinical encounter, namely, patients. This study aimed to describe the correlations between patients’ and observers’ ratings of SDM using 2 validated and 2 nonvalidated SDM measures in clinical consultations. Methods In this cross-sectional study, we recruited 238 complete dyads of health professionals and patients in 5 university-affiliated family medicine clinics in Canada. Participants completed self-administered questionnaires before and after audio-recorded medical consultations. Observers rated the occurrence of SDM during medical consultations using both the validated OPTION-5 (the 5-item “observing patient involvement” score) and binary questions on risk communication and values clarification (RCVC-observer). Patients rated SDM using both the 9-item Shared Decision-Making Questionnaire (SDM-Q9) and binary questions on risk communication and values clarification (RCVC-patient). Results Agreement was low between observers’ and patients’ ratings of SDM using validated OPTION-5 and SDM-Q9, respectively (ρ = 0.07; P = 0.38). Observers’ ratings using RCVC-observer were correlated to patients’ ratings using either SDM-Q9 ( rpb = −0.16; P = 0.01) or RCVC-patients ( rpb = 0.24; P = 0.03). Observers’ OPTION-5 scores and patients’ ratings using RCVC-questions were moderately correlated ( rφ = 0.33; P = 0.04). Conclusion There was moderate to no alignment between observers’ and patients’ ratings of SDM using both validated and nonvalidated measures. This lack of strong correlation emphasizes that observer and patient perspectives are not interchangeable. When assessing the presence, absence, or extent of SDM, it is important to clearly state whose perspectives are reflected.

scholarly journals Prelicensure Nursing Students’ COVID-19 Attitude Impact on Nursing Career Decision during Pandemic Threat in Taiwan: A Cross-Sectional Study

2021 ◽  
Vol 18 (6) ◽  
pp. 3272
Author(s):  
Shu-Chun Lin ◽  
Lee-Fen Ni ◽  
Yu-Ming Wang ◽  
Shu Hsin Lee ◽  
Hung-Chang Liao ◽  
...  
Keyword(s):  
Decision Making ◽  
Nursing Students ◽  
Perceived Control ◽  
Career Decision ◽  
Cross Sectional Study ◽  
Attitude Scale ◽  
Sectional Study ◽  
Career Decision Making ◽  
Cross Sectional ◽  
Prelicensure Nursing

The COVID-19 pandemic may cause a nursing shortage. Prelicensure nursing students who are exposed to high-stress COVID-19 events are related to defective career decision-making. This study validated the COVID-19 attitude scale and clarified how their attitudes about COVID-19 affected their behavioral intentions toward career decision-making. We conducted a cross-sectional study and recruited a convenience sample of 362 prelicensure nursing students from Northern and Central Taiwan. Two measurements were applied, including the Nursing Students Career Decision-making instrument and COVID-19 attitude scale. We used AMOS (version 22.0) to perform a confirmatory factor analysis. The Cronbach α of the COVID-19 attitude scale was 0.74 and consisted of four factors. The most positive attitude was the nursing belief factor, and the least positive factor was emotional burden. Prelicensure nursing students’ COVID-19 attitudes were significantly positively associated with their career decision-making attitudes and perceived control (ß = 0.41 and ß = 0.40, respectively; p < 0.001). All the key latent variables explained significantly 23% of the variance in the career decision-making behavioral intentions module. In conclusion, the COVID-19 attitude scale is valid. Although the prelicensure nursing students’ COVID-19 attitudes had no direct effect on career decision-making intentions, they had a direct effect on career decision-making attitudes and the perceived control.

scholarly journals Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B L O Luizeti ◽  
E M M Massuda ◽  
L F G Garcia
Keyword(s):  
Public Health ◽  
Health System ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Extreme Poverty ◽  
The Public ◽  
The North ◽  
Unified Health System ◽  
Shortage Of Doctors ◽  
Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

scholarly journals Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study

Heliyon ◽  
2021 ◽  
pp. e07755
Author(s):  
Victoria Bam ◽  
Alberta Yemotsoo Lomotey ◽  
Abigail Kusi-Amponsah Diji ◽  
Hayford Isaac Budu ◽  
Dorothy Bamfo-Ennin ◽  
...  
Keyword(s):  
Decision Making ◽  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Influencing

scholarly journals A cross-sectional study of malaria endemicity and health system readiness to deliver services in Kenya, Namibia and Senegal

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii75-iii87 ◽  
Author(s):  
Elizabeth H Lee ◽  
Cara H Olsen ◽  
Tracey Koehlmoos ◽  
Penny Masuoka ◽  
Ann Stewart ◽  
...  
Keyword(s):  
Health System ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Malaria Endemicity ◽  
System Readiness

scholarly journals Student dropout at university: a phase-orientated view on quitting studies and changing majors

2021 ◽  
Author(s):  
Lisa Bäulke ◽  
Carola Grunschel ◽  
Markus Dresel
Keyword(s):  
Decision Making ◽  
Information Search ◽  
Structural Equation ◽  
Cross Sectional Study ◽  
Final Decision ◽  
Cross Sectional ◽  
Confirmatory Factor Analyses ◽  
Student Dropout ◽  
Regulatory Processes ◽  
Present Cross Sectional Study

AbstractStudent dropout can be conceptualized as a decision-making process, consisting of different phases. Based on previous literature on student dropout, decision-making, and action-phases, we proposed that the process of developing dropout intentions includes the following phases: non-fit perception, thoughts of quitting/changing, deliberation, information search, and a final decision. In the present cross-sectional study, we empirically investigated if the assumed phases can be distinguished from each other, if the phases follow the presumed order, and whether each phase is associated with certain characteristics. Furthermore, we considered a strict separation between quitting studies completely and changing a major. For this purpose, we analyzed data of N = 1005 students (average age of 23.0 years; 53% female; 47% male) from a German University. By using confirmatory factor analyses, we found the supposed factor structure for the different phases concerning both kinds of dropout, quitting studies, and changing majors. In each process, structural equation modelling indicated positive relations between adjoining phases. The factor values correlated to a substantial amount with an assortment of variables associated with student dropout. On a theoretical level, the conception of different phases of student dropout helps to get a better understanding of regulatory processes in the context of student dropout.

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